Overreacting to Ebola

October 28th, 2014, 9:24am by Sam Wang

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The amount of Ebola coverage is amazing: 1,869 stories from October 20 to 24 alone. That coverage came on the heels of the death of one patient in Dallas, Texas. The level of coverage is amazing considering the far greater impact of other infectious diseases in the United States: rotavirus, which kills dozens of small children every year; West Nile virus, a similar number of adults; and of course influenza, which kills thousands even in years when there is no epidemic. One way to look at this is to calculate the ratio of stories to deaths. It’s about 6 million times higher for Ebola than for influenza.

Ebola appeals to our fears: the disease is grisly. It is a serious threat with tremendous public health implications – in western Africa. That is the reason for sending relief workers overseas – fighting it there so we don’t have to fight it over here. Unfortunately, popular intuitions about it are often wrong. Many people seem unaware that asymptomatic individuals are not contagious, and the disease is not transmitted by airborne means. It is unfortunate that more coverage does not focus on evidence-based information such as this New England Journal of Medicine editorial.

@SamWangPhD you are more likely to be a living member of The Beatles than to have died of Ebola here.

42 Comments so far ↓

I’m not arguing with the NEJM article, but I am defending the public’s perception of the danger of this outbreak. You can lay this perception, or mis-conception, if that is your view, at the feet of news media like CNN and others of their ilk, as well as at the feet of the CDC, state governments, and the federal government. Bungling, mishandling, and poor communications are a polite way of describing how government mis-handled the “Ebola Crises”. How quickly they recovered and seem to be getting on track speaks well of our system. Better to correct policies on the fly then be hide-bound and stick with policies that don’t work out of stubbornness.

But experts have admitted that Ebola can be transmitted from three feet away by an infected person coughing, and that “bodily fluids” also includes sweat, and that the virus can live on surfaces such as doorknobs and such for well over an hour, maybe longer depending on conditions.

The virus can develop rapidly and come over a person suddenly, so people rightly believe that if a person on a plane or subway or bowling alley suddenly develops a high fever that person will sweat and transfer that sweat to anything they touch. They may also cough and transmit airborne particles to anyone within a three foot radius.

The Doctor who cavalierly rode around New York’s subway system, ate out, and bowled did not do anyone any favors.

I, personally, am as sick of people trying to minimize Ebola’s risk as I am sick of the fear mongering on television.

And the political divide is becoming clear: “Islam is a peaceful religion and Ebola is not very contagious.” versus “Islam is full of hate, intolerance, and violence, and Ebola could become a widespread, deadly outbreak in the US, and government cannot be trusted to protect us.”

I will err on the side of caution in protecting my family and myself. I certainly will not take the word of the CDC or the NEJM.

I don’t feel I have enough information to make a reliable, accurate judgment, and I don’t trust the information at my disposal including that from the vaunted NEJM.

That doctor who rode around the subway was completely asymptomatic, and was following protocol. It’s not his job to assuage the entirely irrational fears of a credulous public pumped up to pitchfork and torches level of hysteria by the news media.

Same for the nurse imprisoned by our governor.

These medical people are actually doing work in West Africa that makes it less likely that Ebola will spread to places like the US.

Seriously, over the next year you are far more likely to die of salmonella or e-coli in your salad.

A thought experiment for you: Let’s say it’s February (the peak of seasonal flu season), and you’ve just flown home from an area where flu is prevalent (in other words, any place in the U.S.). You’re going to voluntarily quarantine yourself in your home, right? Even if you’re asymptomatic, right? It’s the only sensible thing to do, given how many deaths there are each year in the U.S. from seasonal flu.

Ah yes, the age of ignorance: I do not trust the experts because the experts don’t tell me what I, a non-expert, believe to be true. In a scientific world, doctors should inform your opinion, but your fears should not inform doctors.

Many are unaware that asymptomatic individuals are not contagious, and that the disease is not air-borne, because ” news ” organizations like Fox News and commentators like George Will want it that way. They want to re-invent science, particularly if there is a chance that could help Republicans. In other words, it is – for them – far more important to induce an unwarranted state of hysteria if the prize might be a GOP senate, where re-invented science of other sorts would undoubtedly be the order of the day. Only problem is – outside right-wing blogs – the public isn’t buying it. The Fox network has a vested interest in pedaling ignorance. But the polls that have questioned the public on this topic have consistently revealed a dangerously mature and reasoned public.

That’s just silly. Just as many left-leaners and pundits are all in with the scare. I know, I know, you need for this to be a Republican / Democrat dichotomy of good guys vs bad guys. And I understand the incessant angst-ridden hand wringing over the ostensible ratings success of Fox News, but to transform this story from a general Ebola overreaction into a Republican conspiracy to win the Senate defies rational thinking. Ebola stories are everywhere.

However, I do think it is advantageous to the GOP, if for no other reason that it stops the clock (this was floated by someone prominent on the GOP side who I met the other day). There is also the fact that fear of alien threats is of great interest to the GOP base.

Yes, CNN has been doing it too. These past few years, their strategy appears to be: Try to be as crazy as Fox News no matter what issue it is. However, whenever they think they have matched Fox’s craziness, they discover that Fox has got even crazier!

This is where innumeracy is harmful to society. People do not know how to calculate basic probability of something happening, and they intuit the danger from the frequency of television reports.

Several thousand Americans are going to die from influenza. There is a vaccine but innoculation rates are abysmal.

Reading over the transcript from your CNN appearance it seems they would have been better served using your expertise to comment on the Ebola issue earlier in the program, both as a biologist and a statistics guru.

We should recall the hysteria that we had over HIV. Children were banned from schools, funeral homes refused bodies that had died of AIDS. Magic Johnson felt forced to retire. Yet despite the fear of salvia, urine, and coming in contact with blood, I cannot recall that any person has even alleged that they became infect by casual contact. AIDS cannot be cured but can be successfully managed. Ebola seems to have responded well to early detection in the U.S. It is time we took a chill pill. Science should trump myth and fear.

Unfortunately most people don’t know anything about the AIDS crisis in this country. Or about the fact the Reagan administration was the leader both vocally and medically through their refusal to speak about it or fund research. It was immoral then and similar behavior now is just as bad.

Also, while the real disease is terrible enough, the book The Hot Zone did a lot way back in the Nineties to make people believe Ebola is more grisly than it actually is, with its images of people liquefying into contagious blood-balloons.

Television faces this quandry when confronted by an ongoing public emergency. The instinct is to make it grisly and terrifying, that makes a better story and attracts more viewers. This conflicts with their other job to educate the public while the emergency is going on. Grisly story wins.

I suppose books like The Hot Zone have this conflict as well, but their impact isn’t as immediate of as big mostly because Americans don’t read much.

We’ve long ago crossed over the line from taking actions to try to calm people’s hysteria over this, to taking actions that cater to that hysteria, which thereby encourages even greater hysteria. It’s good to see our leaders taking even a half-step back toward sanity on this issue.

On what data do the authors of the editorial base their claim that a 21-day quarantine such as that presently in use by the US Army as a precautionary measure will hinder volunteer efforts? I saw no data in support of that claim in the editorial.

In an editorial focused on the importance of letting science guide decision making, it’s an odd omission. The authors argue in part that a quaratine will hinder volunteer efforts, but they provided no science in support of that particular claim.

So, you want to see data from a study that has not been done? Arguments can’t always be based on data, since there are always going to be things that we simply don’t have any data about. There’s no polling data for the congressional race in my district, but I know damned well who’s going to win.

The argument for quarantine is purely conjectural, so why can’t one argue against quarantine with reasonable inferences about the possible consequences? Unless the authors are claiming that there is scientific data but refusing to disclose it, I’m not entirely sure what your complaint is.

The Army’s decision to quarantine troops returning from low-risk deployments in West Africa will compromise the Army’s readiness to fulfill other missions simply by making those troops unavailable for other duty for three weeks. That’s axiomatic. No data required.

By the way Sam – I have a strange story to share with you. I actually bought your book “Welcome to Your Brain” sometime ago and read and enjoyed it but I guess never really memorized your name … and then I came across your blog here and read it for quite some time … and then later on Amazon.com I saw your book (recommended to me or something) and saw your name on it and put it all together. You’re the same guy that wrote that book! Not sure what that says about my brain.

But I am not overracting to Ebola. I may be overracting to my fear of a Republican controlled Senate … but I don’t think so. I’m pretty sure it’s a far more dangerous thing for the country.

And the crazy thing is, research suggests that merely *thinking* about germs and infectious diseases has profound effects on our political identification across the board….

“Standing near hand sanitizer makes Americans more conservative. So what will Ebola do?”
[…]
“On average, students in the control group rated themselves a 4.93 on a scale where 1 was extremely conservative and 7 was extremely liberal. But students who were cued to think about the hand sanitizer rated themselves, on average, a 4.30 — and the difference held on fiscal, social, and moral issues.”

Yes, indeed. Consider also how much coverage ISIS and perceived terrorist threats are getting. However, even the number of people who died in 9/11 (2996) (note: in New York, not during the US-supported Chilean coup) pales in comparison to deaths due to 1) drunk drivers (9878 in 2011), 2) gunshots (approx. 100,000)…

Tomorrow will mark 21 days since Mr. Duncan succumbed to Ebola. That means that, despite the error of his release on his first ER visit, there was no community-based transmission of the virus. And of course, the two nurses who contracted the disease while caring for him are now well and no longer contagious. Somehow, I seem to have missed the press coverage of all this good news.

I’m also struggling to find the coverage of the fact that all of the errors in Mr Duncan’s case were made by a private hospital and state and local officials, rather than the federal government.

What happens the first time someone who is actively contagious is on a plane flight to a major city and only collapses in the airport terminal after everybody gets off the flight and the government hasn’t planned for this?

There’s no need to wonder, because it happened three months ago. You can even find out who actually caught it, how people involved responded to various government policies, and that sort of thing. Of course, since it was already over before the Dallas case started, media and politics pretty much ignores it.

I don’t know what you mean by actively contagious. Perhaps, you mean symptomatic. It seem clear that it takes a couple of days to get a viral load sufficient to infect even at that. Plus you still have to come in contact with bodily fluids that have sufficient viral load to infect.

How many of the US media stories were about Ebola in Africa, how many about Ebola’s biology and history, and how many about Ebola in the USA? Ebola in Africa is world news of serious import, like any rampant plague anywhere. Other health issues like AIDS, alcoholism, and obesity are not doubling every month anywhere, as far as I know. The problem is not that media are covering Ebola. The problem is that coverage seems to be focusing far from where the epidemic is happening, and not focusing on measures to bring it under control and ending it. Sort of like focusing on kitchen fire extinguishers because of a rash of big forest fires.

Thank you, Rachel. Please everyone stop being so callous and myopic. It’s not about Ebola’s effect on a US election or the extraordinarily small chance that many North Americans will be afflicted. Ebola is a big story but not what the media has focused on. It is a horrific tragic story for many, many Africans. Its highly adverse effects on the well being of Africans goes far beyond the immediate and terrible suffering of those with the disease. Sadly, the discussion in the media and on this website seems to be focused on how Ebola is affecting us, whether we are at risk, whether it is an election issue, etc. These are small issues compared to the suffering of real people across the Atlantic.

You mean there exists a small but finite chance that a person could find themselves married to a Kardashian sister? Shouldn’t the government do something? If there is no vaccine, then at least some sort of education campaign on how to keep yourself safe.

Thankfully, the media (especially the tabloid media) are doing a good job by publicizing every Kardashian wedding.

Those who are skeptical as to whether Republicans are actively trying to run with this need only visit a number of battleground states, turn on the TV, and see a stream of partisan ads – all of them Republican – that tie ever more elaborate conspiracy theories – linking Ebola with Mexican drug cartels, terrorism, and even tying it in with immigration. It’s all about fear, and every last one of these ads are Republican. Non-partisan ? Please.

Hmm…and there is one major cause of death missing from the chart – gunshot wounds. True, not an infectious disease, but far more Americans die from guns and we don’t see the hysterics over them. At first the parallel may appear to be a straw man…perhaps it is…but in one case you have a society moving to curtail an individual’s rights if they deem them at risk of being sick, but nonchalant about individuals at high risk of committing violent gun crimes.

Thank you, all the other websites are just hysterical. Everyone from any plane flying over the African continent should be quarantined. The MSF nurse should be thrown in jail, have her license revoked, be sent back to Africa. That poor nurse who barely escaped the unheated tent violated her quarantine by bike riding in the woods. All bears in Maine should now be quarantined, I suppose.

As of today there is one person in the entire US that is positive for Ebola, the Dr. from NYC. Meanwhile 80 people a day day from firearms (homocide, suicide and accidental death). Panic? No just collateral damage.